Surgical stapling apparatus having a wound closure material applicator assembly

ABSTRACT

This disclosure relates to surgical stapling apparatus for enhancing one or more properties of body tissue that is or is to be repaired or joined. The apparatus includes a staple anvil, a staple cartridge, a driving member for driving the surgical staples from individual staple slots in the staple cartridge and against the staple anvil, and a wound closure material applicator assembly. The applicator assembly includes at least one conduit extending along at least a length of the driving member, anvil and/or cartridge and at least one reservoir in fluid communication with the at least one conduit, the reservoir containing a wound closure material therein. The staples can be coated with a wound to closure material.

CROSS-REFERENCE TO RELATED APPLICATIONS

The present application claims the benefit of and priority to U.S.Provisional Application Ser. No. 60/379,956 filed on May 10, 2002, theentire contents of which are incorporated herein by reference.

BACKGROUND

1. Technical Field

This disclosure relates to surgical stapling apparatus, and moreparticularly, to a surgical stapling apparatus having a wound closurematerial applicator assembly for applying a plurality of surgicalfasteners to body tissue and dispensing a quantity of wound closurematerial, such as an astringent, to reduce and/or prevent staple lineand/or knife cut line bleeding.

2. Background of Related Art

Surgical procedures requiring cutting of tissue can result in bleedingat the site of the cutting. Various techniques have been developed tocontrol bleeding with varying degrees of success such as, for example,suturing, applying clips to blood vessels, and using surgical fasteners,as well as electrocautery and other tissue healing techniques.

Surgical instruments using surgical fasteners entail grasping orclamping tissue between opposing jaw structure and then joining thetissue by employing the surgical fasteners. These instruments are wellknown in the art. In some instruments a knife is provided to cut thetissue which has been joined by the fasteners. The fasteners aretypically in the form of surgical staples however, two part polymericfasteners can also be utilized.

Instruments for this purpose can include two elongated or circularmembers which are respectively used to capture or clamp tissue.Typically, one of the members carries a cartridge which houses aplurality of staples arranged in at least two lateral rows while theother member carries an anvil which defines a surface for forming thestaple legs as the staples are driven from the cartridge. Where two partfasteners are used, one of the members carries a cartridge which housesone half of a fastener while the other member carries the second part ofthe fastener, e.g., the mating part, which halves are configured andadapted to be held together upon approximation. Typically, the staplingoperation is effected by a drive member which travels longitudinallythrough the cartridge carrying member, with the drive member acting uponthe pushers which engage the staples to sequentially eject them from thecartridge. A knife can be provided which travels between the staple rowsto longitudinally cut (i.e., form a knife cut line) and/or open thestapled to tissue between the rows of staples. Usually, but not always,the knife is associated with or travels with the staple drive member.Such instruments are disclosed in U.S. Pat. Nos. 3,079,606 and3,490,675, the entire contents of which are incorporated herein byreference.

A later stapler disclosed in U.S. Pat. No. 3,499,591, the entirecontents of which are incorporated herein by reference, applies a doublerow of staples on each side of the incision or the knife cut line. Thisis accomplished by providing a cartridge assembly in which a cam membermoves through an elongate guide path between two sets of staggeredstaple carrying grooves. Staple drive members are located within thegrooves and are positioned in such a manner so as to be contacted by thelongitudinally moving cam to effect ejection of the staples. Otherexamples of staplers are disclosed in U.S. Pat. Nos. 4,429,695,5,065,929 and 5,156,614, the entire contents of which are incorporatedherein by reference.

Electrocautery devices are preferred in certain surgical procedures foreffecting improved hemostasis by heating tissue and blood vessels usingthermogenic energy, preferably radiofrequency energy, to causecoagulation or cauterization. Monopolar devices utilize one electrodeassociated with a cutting or cauterizing instrument and a remote returnelectrode, usually adhered externally to the patient. Bipolarinstruments utilize two electrodes and the cauterizing current isgenerally limited to tissue between the two electrodes of a tissuetreating portion (e.g., end effector) of an instrument.

Even though stapling apparatus and electrocauterizing apparatus andtechniques respectively are generally well suited to control bleedingalong the knife cut line, other apparatus and techniques are hereinenvisioned.

Therefore, it is an aspect of the present disclosure to provide asurgical stapling apparatus that provides general hemostatis, tissuejoining or welding, and also applies a wound closure material to bodytissue that enhances one or more properties of the body tissue that isor is to be repaired or joined, for example, hemostatis along a cut lineformed by a knife or other cutting means and/or along a staple line toreduce or prevent bleeding along the cut line and/or staple line.

SUMMARY

The present disclosure relates to surgical stapling apparatus, and moreparticularly, to a surgical stapling apparatus having a wound closurematerial applicator assembly for applying a plurality of surgicalfasteners to body tissue and dispensing a wound closure material, suchas an astringent, to prevent staple line and knife cut line bleeding.

According to one aspect of the present disclosure, a surgical staplingapparatus for enhancing one or more properties of body tissue that is oris to be repaired or joined is provided. The surgical stapling apparatusincludes a staple anvil positioned on a distal end of the staplingapparatus and having a working surface and a staple cartridge positionedadjacent a distal end of the stapling apparatus and juxtaposablerelative to the staple anvil. The staple cartridge includes a workingsurface, one or more rows of individual staple slots formed in theworking surface, and a plurality of surgical staples individuallydisposed within the individual staple slots. The staple apparatusfurther includes a driving member for firing the surgical staples fromthe individual staple slots and against the staple anvil and a woundclosure material applicator assembly operatively associated with thestapling apparatus. The wound closure applicator assembly includes atleast one conduit extending along at least a length of the drivingmember, and at least one reservoir in fluid communication with the atleast one conduit, the reservoir being for containing a wound closurematerial therein, and the conduit having at least one opening and beingadapted to provide wound closure material therethrough to an areabetween the working surface of the staple anvil and the staplecartridge.

The at least one conduit can include a plurality of openings formedtherein for dispensing the wound closure material therefrom.Longitudinal translation of the driving member causes longitudinaltranslation of the at least one conduit across at least some of theindividual staple slots, such that at least one of the plurality ofopenings is in communication with at least one of the staple slots.

It is envisioned that the at least one reservoir can be compressible.Accordingly, compression of the at least one reservoir causes the woundclosure material to be dispensed from the at least one opening of the atleast one conduit. It is contemplated that the apparatus includes acompression member that effects the compression of the at least onereservoir.

The wound closure material can be an astringent, a sulphate of aluminum,an adhesive, a hemostat and/or a sealant.

The at least one conduit can be positioned across at least some of theindividual staple slots such that compression of the at least onereservoir dispenses the wound closure to material through the at leastsome staple slots.

In an embodiment, each of the plurality of surgical staples is coatedwith the wound closure material.

The driving member can include a pair of elongate beams, and theapplicator assembly can include a pair of conduits extending, one each,along a length of the respective beams. Each of the pair of conduits canhave at least one opening therein and being in fluid communication withthe at least one reservoir. Each of the pair of conduits includes aplurality of openings formed therein. Longitudinal translation of thedriving member causes longitudinal translation of the pair of conduits,such that at least one of the plurality of openings is in communicationwith at least one of the staple slots.

It is envisioned that the wound closure material is an astringent, anadhesive, a hemostat and/or a sealant.

It is envisioned that when the pair of conduits is positioned across atleast some of the individual staple slots, compression of the at leastone reservoir dispenses the wound closure material through the at leastsome staple slots.

Each of the plurality of staples can be coated with wound closurematerial.

According to another aspect of the present disclosure, a surgicalstapling apparatus for enhancing one or more properties of body tissuethat is or is to be repaired or joined is provided and includes a staplecartridge positioned adjacent a distal end of the stapling apparatus,and a plurality of surgical staples disposed within the staplecartridge, the surgical staples being coated with a wound closurematerial.

The wound closure material can be an astringent, an adhesive, a hemostatand a sealant.

According to yet another aspect of the present disclosure a disposableloading unit for use with a surgical stapling apparatus for enhancingone or more properties of body tissue that is or is to be repaired orjoined, the surgical stapling apparatus being of the type having aframe, a first shaft having a distal end, and an actuation mechanism todrive a drive member distally through the shaft is provided. Thedisposable loading unit includes an elongated shaft having a distal endand a proximal end adapted to be operably connected to the distal end ofthe first shaft, a staple anvil positioned on a distal end of theelongated shaft and having a working surface, and a staple cartridgepositioned adjacent a distal end of the elongated shaft and juxtaposablerelative to the staple anvil. The staple cartridge includes a workingsurface, one or more rows of individual staple slots formed in theworking surface, and a plurality of surgical staples individuallydisposed within the individual staple slots, and at least one conduitextending along at least a length of the removable staple cartridge.

The at least one conduit can be adapted to be in fluid communicationwith at least one reservoir, the reservoir being for containing a woundclosure material. The at least one conduit can include at least oneaperture formed therein.

The reservoir is formed of a compressible material, wherein compressionof the reservoir will dispense the wound closure material from the atleast one aperture formed in the at least one conduit.

It is envisioned that the plurality of staples are coated with woundclosure material.

The wound closure material can be an astringent, an adhesive, a hemostatand a sealant.

The disposable loading unit can include a pair of conduits extending,one each, along lateral sides of the staple cartridge. The pair ofconduits are preferably in proximity to the working surface.

It is envisioned that the working surface can be provided with a seriesof apertures formed along a length thereof and wherein the wound closurematerial is dispensed through the apertures formed in the length of theworking surface.

The disposable loading unit can be used in a surgical stapling apparatusfor performing an open gastrointestinal anastomosis surgical procedureor endoscopic or laparoscopic gastrointestinal surgical procedures.

In yet another aspect of the present disclosure, a surgical staplecartridge configured and adapted to be removably received within asurgical stapler is provided. The staple cartridge includes a workingsurface, one or more laterally spaced apart rows of staple slots formedin the working surface, a plurality of surgical staples disposed, oneeach, within the staple slots for mechanically securing adjacent layersof body tissue to one another, and at least one conduit extending alongat least a length of the staple cartridge, the at least one conduithaving a plurality of openings along the majority of the length of theconduit and being adapted such that the plurality of openings cancommunicate with a plurality of the staple slots, the conduit having aconnection for connection to a supply of wound closure material.

The connection can be fluidly connectable to at least one reservoir forcontaining the wound closure material therein. The plurality ofapertures preferably includes a plurality of microtubes.

The reservoir can be formed of a compressible material, such thatcompression of the reservoir will dispense a wound closure material fromthe reservoir through the apertures formed in the at least one conduit.

Each of the plurality of staples is preferably coated with wound closurematerial. The wound closure material can be an astringent, an adhesive,a hemostat and/or a sealant.

The surgical staple cartridge can include a pair of conduits extending,one each, along walls of the removable staple cartridge. The pair ofconduits are in proximity to the working surface.

The working surface can be provided with a series of apertures formedalong a length thereof and wherein the wound closure material isdispensed through the apertures formed in the length of the workingsurface.

In still a further aspect of the present disclosure, a surgical staplingapparatus for enhancing one or more properties of body tissue that is oris to be repaired or joined is provided. The surgical stapling apparatusincludes a staple anvil positioned on a distal end of the staplingapparatus. The staple anvil includes a working surface, a longitudinalcavity formed in the working surface, a plurality of staple formingrecesses formed in the working surface, and a wound closure materialretained in at least a length of the staple anvil for dispensing woundclosure material into, onto the body tissue.

The wound closure material is preferably retained in the longitudinalcavity. It is envisioned that the longitudinal cavity can be a knifetrack.

It is contemplated that the surgical stapling apparatus can include aknife blade operatively connected thereto, wherein the knife blade iscoated with a wound closure material.

Further features of the surgical stapling apparatus of the presentdisclosure will become more readily apparent to those skilled in the artfrom the following detailed description taken in conjunction with thedrawings.

BRIEF DESCRIPTION OF THE DRAWINGS

Various embodiments of the surgical stapling apparatus of the inventionwill be to described hereinbelow with reference to the drawings wherein:

FIG. 1A is a perspective view of a surgical stapling apparatus includinga wound closure material applicator assembly constructed in accordancewith a preferred embodiment, with the clamping handle of the apparatusdisposed in an upright open position;

FIG. 1B is a perspective view of the surgical stapling apparatusillustrated in FIG. 1A with the clamping handle disposed in a closedposition;

FIG. 2A is an exploded perspective view of the surgical staplingapparatus of FIG. 1A;

FIG. 2B is a perspective view of a surgical stapling apparatus having awound closure material applicator assembly constructed in accordancewith another preferred embodiment;

FIG. 3 is a perspective view of a cartridge half-section of the surgicalstapling apparatus of FIG. 1A;

FIG. 4A is a top plan view of a retention channel of the surgicalstapling apparatus of FIG. 1A;

FIG. 4B is a side elevational view of the retention channel shown inFIG. 4A;

FIG. 4C is a perspective view of the retention channel of FIGS. 4A and4B with a disposable loading unit retained therein;

FIG. 5A is an enlarged perspective view, with parts separated, of thedisposable loading unit and actuation assembly of the surgical staplingapparatus of FIG. 1A;

FIG. 5B is an enlarged perspective view of the indicated area in FIG. 5Ashowing the engagement of the cartridge lip and the retention channel;

FIG. 5C is an enlarged perspective view, with parts separated, of thedisposable loading unit and actuation assembly of the surgical staplingapparatus of another embodiment of the subject application;

FIG. 5D is an enlarged perspective view of the indicated area in FIG. 5Cshowing the engagement of the cartridge lip and the retention channel;

FIG. 6A is a perspective view of the actuation sled of the disposableloading unit shown in FIG. 5A in a pre-formed condition;

FIG. 6B is a perspective view of the actuation sled shown in FIG. 6A ina formed condition with the knife blade separated therefrom forillustrative purposes;

FIG. 6C is a perspective view of the formed actuation sled shown in FIG.6B with the knife blade mounted to the blade support portion thereof;

FIG. 6D is an enlarged cross-sectional view of a knife blade, inaccordance with the present disclosure, as taken through line 6D-6D ofFIG. 6B;

FIG. 6E is an enlarged cross-sectional view of a surgical staple, inaccordance with the present disclosure;

FIG. 7 is a plan view of the preformed anvil plate which is mounted tothe anvil support beam of the anvil half-section of the surgicalstapling apparatus shown in FIG. 1A;

FIG. 8 is a cross-sectional view of the preformed anvil plate takenalong line 8-8 of FIG. 7;

FIG. 9 is a front end view of the preformed anvil plate illustrated inFIGS. 7 and 8;

FIGS. 9A-9G are front end views of preformed anvil plates includingwound closure material applicator systems operatively associatedtherewith;

FIG. 10 is a perspective view of the anvil half-section of the surgicalstapling apparatus of FIG. 1A with an enlarged localized view of adistal portion thereof illustrating the connective engagement betweenthe anvil plate and the anvil support beam;

FIG. 11 is an exploded perspective view of a lockout mechanism toprevent reactuation of the apparatus;

FIG. 11A is an enlarged cross-sectional view of the T-shaped member ofthe lockout mechanism;

FIG. 12 is an enlarged perspective view of the actuation channel havingan edge for engagement by the hook of the lockout mechanism;

FIGS. 13A and 13B are side views of the lockout mechanism illustratingits movement from a non-engaged to an engaged position;

FIG. 14 is a side elevational view in cross-section of the surgicalstapling apparatus of the present invention with the actuation sleddisposed in a pre-actuated proximal position;

FIG. 15 is a side elevational view in cross-section of the surgicalstapling apparatus of the present invention with the actuation sleddisposed in a partially advanced position;

FIG. 16 is a side elevational view in cross-section of the surgicalstapling apparatus of the subject application with the actuation sledadvanced to the distal end of the cartridge and, illustrating thedistribution of a substance at least along at least one staple line atthe conclusion of a staple firing procedure;

FIG. 17 is a perspective view of an alternative surgical staplingapparatus having a wound closure material applicator assemblyoperatively associated therewith;

FIG. 18 is a perspective view of a distal end of the surgical staplingapparatus of FIG. 17;

FIG. 19 is an exploded perspective view of the surgical staplingapparatus of FIG. 17;

FIG. 20 is a perspective view of yet another surgical stapling apparatushaving a wound closure material applicator assembly operativelyassociated therewith; and

FIG. 21 is a perspective view of a distal end of the surgical staplingapparatus of FIG. 20.

DETAILED DESCRIPTION OF PREFERRED EMBODIMENTS

Preferred embodiments of the presently disclosed surgical staplingapparatus will now be described with reference to the drawing figureswherein like reference numerals identify similar or identical elements.In the drawings and in the following description, the term “proximal”,as is traditional, will refer to the end of the apparatus which iscloser to the operator, while the term “distal” will refer to the end ofthe apparatus which is further from the operator.

The present invention provides a surgical stapling apparatus having awound closure material applicator assembly which applies to body tissueat least one wound closure material, for example, an astringent, whichcauses small blood vessels to constrict or close, or a coagulant to helpthe blood to coagulate, as well as surgical fasteners or staples forproviding hemostasis, tissue joining or welding. The use of at least onewound closure material for example can provide short, i.e., temporary,and long-term, i.e., permanent, hemostasis and sealing, and reduce orprevent bleeding along a staple line and/or a knife cut line, while thefastening or stapling feature provides short and long-term tissuestrength and hemostasis.

Since staple line and knife cut line bleeding is reduced or prevented,the surgical stapling apparatus of the present invention makes itpossible to expand the applicable range of specific staple sizes toinclude thinner or, thicker staples used in highly vascularized tissue.For example, it is contemplated that relatively large-size staples couldbe used with the surgical stapling apparatus of the present invention tojoin thin, highly vascularized tissue.

Referring now to the drawings wherein like reference numerals identifysimilar structural elements, there is illustrated in FIGS. 1A and 1B asurgical stapling apparatus, in accordance with a preferred embodimentof the present disclosure, is designated generally as reference numeral10. Surgical stapling apparatus 10 includes a cartridge half-section 11a and an anvil half-section 11 b.

Referring to FIGS. 2A, 2B and 3, stapling apparatus 10 includes a bodyportion 12 defining a handle for grasping and supporting the staplingapparatus 10. A retaining channel 14 is mounted in the interior cavity15 of body portion 12 adjacent the distal end thereof. Retaining channel14 is dimensioned and configured to support a disposable loading unit20, as illustrated in FIG. 4C.

As shown in FIG. 5A, disposable loading unit 20 includes a cartridge 22having a tissue contacting or working surface 29, a plurality of slots22 c which support a corresponding number of surgical staples 24, aplurality of staple pushers or ejectors 26 adapted and configured toeject staples 24 from the slots 22 c when acted upon by a staple drivingforce. Stapling apparatus 10 further includes an actuation sled 28slidably disposed in retention channel 14 (see FIG. 2A) to translatethrough cartridge 22 in a longitudinal direction to transmit a stapledriving force to ejectors 26.

According to a preferred embodiment of the invention, surgical staples24 are preferably coated (understood to include treated) with at leastone wound closure material, such as an astringent, e.g., a sulphate ofaluminum, which causes small blood vessels to close and helps the bloodto coagulate. It is provided that the astringent used could be thatprovided in the material commercially available under the tradedesignation No Nix Styptic Pencils from Requa, Inc.

Cartridge 22 is preferably fabricated from liquid crystal polymermaterial, such as liquid crystal polymer resin, commercially availablefrom Plasticsnet.com under the trademark Xydar, although other materialsarc contemplated. Cartridge 22 has a lip 23 which engages retentionchannel 14 to prevent inward rotation of cartridge 22 (see FIG. 5B).

As best seen in FIG. 6A, actuation sled 28 is preferably monolithicallyformed from a single piece of sheet metal which is folded into thedesired structural configuration shown in FIGS. 6B and 6C. In thisconfiguration, actuation sled (staple actuator) 28 defines a baseportion 30, two upstanding cam wedges 32 and 34, and an upstanding shankto 35 which supports a knife blade 36. Knife blade 36 is preferably spotwelded to shank 35, although other known fastening methods, e.g.,clamping, may be employed. As illustrated in FIG. 6B, a weldment port 37and a winglet 39 are provided to facilitate the proper alignment andcohesion of knife blade 36 to shank 35 during fabrication. Actuationsled 28 can also be non-monolithically formed.

According to another embodiment of the invention, as seen in FIGS. 6Dand 6E, knife blade 36 is preferably itself, or in combination withstaples 24, treated or coated with at least one wound closure material“W”, such as an astringent, e.g., a sulfate of aluminum. In such cases,the at least one wound closure material “W” can be a particulate,preferably a powder or coating, which has been coated on knife blade 36and staples 24. In particular apparatus, the at least one wound closurematerial “W” preferably is fluid soluble (i.e., water soluble) oractivatable upon exposure to fluid (e.g., water, saline, blood, etc.).

Cam wedges 32 and 34 are longitudinally staggered with respect to oneanother so that one leads the other throughout the sled's translationthrough cartridge 22. As shown in FIG. 5A, longitudinal slots 22 a and22 b accommodate the longitudinal translation of cam wedges 32 and 34,while slot 22 d accommodates the longitudinal translation of shank 35.

The base portion 30 of actuation sled 28 has a transverse slot 40defined _(t)herein which is dimensioned and configured to releasablyretain an upturned flange 42 formed at the distal end of elongateddriving member, here, actuation channel 44 (FIG. 5A). When thedisposable loading unit 20 is placed into retaining channel 14 andactuation sled 28 is disposed in its proximal-most position, flange 42releasably engages slot 40. Thus, movement of actuation channel 44 movesactuation sled 28. After a stapling operation, when disposable loadingunit 20 is removed from the retaining channel, flange 42 is easilydisengaged from slot 40.

With continued reference to FIG. 5A, actuation channel 44 is defined bya base portion 45 and two parallel upstanding beams 46 and 48 ofelongate configuration. The distal ends of beams 46 and 48 are staggeredto match the staggered orientation of cam wedges 32 and 34,respectively. The proximal end of each beam projects rearwardly toengage a mounting block 49 that is associated with firing knob 50. Apair of slots 52 (only one of which is shown) are formed in mountingblock 49 for receiving the proximal end of each of the upstanding beams46, 48 of actuation channel 44 and the slots are provided with detents54 for engaging apertures 56 in the beam ends to lockingly retain beams46, 48 in mounting block 49. In use, longitudinal movement of firingknob 50 causes corresponding longitudinal translation of actuationchannel 44 and actuation sled 28.

As seen in FIGS. 1A-3, surgical stapling apparatus 10 includes a woundclosure material applicator assembly 17 (see FIG. 2B) operativelyassociated therewith. As seen in FIG. 5A, wound closure materialapplicator assembly 17 can include two conduits 8 secured to andextending, one each, along an upper edge of beams 46, 48 of actuation ischannel 44. Each conduit 8 includes a plurality of openings 7 formedalong a length thereof, preferably along an upper portion thereof, fordispensing at least one wound closure material “W”, preferably upwardlytherefrom. In use, longitudinal translation of actuation channel 44causes longitudinal translation of conduits 8 through staple cartridge22.

Conduits 8 have sufficient slack to enable longitudinal movement orextension through body portion 12 and cartridge 22 in order for the atleast one wound closure material “W” to be applied along the entirelength of a knife cut line formed by knife blade 36 and along at leastone staple line formed by surgical staples 24 (see FIG. 16). Theconduits 8 are adjoined at location A, as shown by FIGS. 3, 5A, 11 and12, and form one conduit 8 a which exits body portion 12 via an opening9 (see FIGS. 1A and 1B). Conduit 8 a is in fluid communication with atleast one reservoir 4 which contains/stores or is adapted tocontain/store at least one wound closure material “W” (see FIG. 2A)therein.

Reservoir 4 is preferably a compressible tube or container. However,other types of reservoirs are contemplated such as more rigidsyringe-like reservoirs. In one embodiment, as seen in FIG. 2B,reservoir 4 is compressible and configured for placement between thefirst and second body portions of apparatus 10 in order to be compressedas pivoting lever handle 100 is moved towards body portion. It isenvisioned that reservoir 4 can be removably coupled to conduit 8 a viaa coupling. In this manner, reservoir 4 can be replaced as needed, suchas, for example, when reservoir 4 has emptied, when a different woundclosure material “W” is desired and so forth.

In use, with conduits 8 extended along or under the staple line,compression of reservoir 4 causes wound closure material “W” to be urgeddistally through conduit 8 and dispensed from openings 7 along thestaple line and/or the knife cut line either prior to, during or afterthe staple firing procedure. In this embodiment, as seen in FIGS. 14-17,wound closure material “W” that is urged from openings 7 in conduits 8is dispensed through staple slots 22 c. In an alternative method of use,as actuation channel 44 is axially moved, here distally advanced, toextend conduits 8 along the staple line(s), conduits 8 are concomitantlysqueezed/compressed (by actuation channel 44 passing across staplepushers 26 and/or between the walls of longitudinal slots 22 a, 22 b) inorder to dispense wound closure material “W” therefrom. In thisembodiment, compression can also be applied to reservoir 4.

Turning now to FIGS. 5B-5D, in an alternative embodiment, two conduits8′ extend longitudinally along opposite sides of disposable loading unit20 of cartridge 22. Conduits 8′ meet at a proximal end of cartridge 22indicated by the letter “A′” to form a main conduit 8 a′. Each conduit8′ includes a plurality of micro tubes 21 (only five of each conduit 8′are shown) for feeding the at least one wound closure material “W” to orabove a tissue contacting or working surface of cartridge 22 viaopenings 27 formed therein. Alternatively, microtubes can pass throughholes placed through the outer walls of cartridge 22 and up to openings27 in the cartridge working surface. Microtubes 21 and openings 27 canbe angularly disposed to direct wound closure material toward thelongitudinal center line of the working surface. Alternatively, holescan be provided in the walls defining longitudinal slots 22 a, 22 b tocommunicate with the lower portions of staple slots 22 c, to feed thewound closure material through the slots.

It is envisioned that conduit 8 a′ is connected to a syringe or areservoir, for example, reservoir 4 (see FIG. 2B), which stores the atleast one wound closure material “W”. The at least one wound closurematerial “W” can be manually or automatically dispensed via tubes 21 andopenings 27.

For example, the at least one wound closure material “W” can be manuallydispensed by directly squeezing reservoir 4 in the hand of the surgeonby indirectly squeezing reservoir 4 between lever handle 100 andcartridge half-section 11 b. Alternatively, the at least one woundclosure material “W” can be automatically dispensed by one or morepneumatic systems (“PS” shown in dashed lines).

It is envisioned that wound closure materials “W” include but are notlimited to adhesives, hemostats and sealants. Surgical biocompatiblewound closure materials which can be employed in or applied the surgicalinstruments, especially surgical staplers, include adhesives whosefunction is to attach or hold organs, tissues or structures, sealants toprevent fluid leakage, and hemostats to halt or prevent bleeding.Examples of adhesives which can be employed include protein derived,aldehyde-based adhesive materials, for example, the commerciallyavailable albumin/glutaraldehyde materials sold under the tradedesignation BioGlue™ by Cryolife, Inc., and cyanoacrylate-basedmaterials sold under the trade designations Indermil™ and Derma Bond™ byTyco Healthcare Group, LP and Ethicon Endosurgery, Inc., respectively.Examples of sealants which can be employed include fibrin sealants andcollagen-based and synthetic polymer-based tissue sealants. Examples ofcommercially available sealants are synthetic polyethylene glycol-based,hydrogel materials sold under the trade designation CoSeal™ by CohesionTechnologies and Baxter International, Inc. Examples of hemostatmaterials which can be employed include fibrin-based, collagen-based,oxidized regenerated cellulose-based and gelatin-based topical hemostatsherein can include astringents and coagulants. Examples of commerciallyavailable hemostat materials are fibrinogen-thrombin combinationmaterials under sold the trade designations CoStasis™ by Tyco HealthcareGroup, LP and Tisseel™ sold by Baxter International, Inc. Hemostatsherein include astringents, e.g., sulphates of aluminum, and coagulants.

Referring to FIGS. 2A and 4C, retention channel 14 includes a baseportion 60 and two upstanding parallel walls 62 and 64. Numericalindicia are imprinted on the walls 62, 64 of retention channel 14 toindicate the length of the staple line. Retention structures in the formof notches 66 a, 66 b are respectively provided at the distal end ofeach of walls 62, 64 to engage cooperating structures in the form ofprotuberances 67 provided on the disposable loading unit 20. Similarlyslots 68 a and 68 b are provided at the distal end of each of walls 62,64 for engaging corresponding detents 69 provided on disposable loadingunit 20. These structures inhibit lateral, longitudinal andperpendicular shifting of the cartridge 22 (and disposable loading unit20) within the retaining channel 14. Ramped engagement slots 70 a and 70b are also defined in the opposed walls of retention channel 14 forinteracting with a pair of opposed protuberances 72 a and 72 b ofdisposable loading unit 20 (FIG. 5A) to guide disposable loading unit 20into retention channel 14 when loaded into the surgical staplingapparatus 10.

Referring again to FIG. 2A, the surgical stapling apparatus 10 furtherincludes an elongate anvil support beam 80 which has a generallyU-shaped cross-sectional configuration. Proximal end portion 82 ofsupport beam 80 has a notched area 84 for engaging a pair ofcorresponding detents 86 (only one of which is shown), which extend intothe cavity 15 of body portion 12 adjacent the proximal end thereof.Detents 86 are engaged when cartridge half-section 11 a and anvilhalf-section 11 b are mated with one another. Distal end portion 88 ofanvil support beam 80 is configured to support a to preformed anvilplate 90 against which staples 24 are driven and formed during astapling procedure.

Referring to FIGS. 7 and 8, anvil plate 90 can be formed from a unitarypiece of metal and cold formed and stamped to define a plurality ofstaple forming recesses or cups 91. Each staple forming recess 91corresponds to a particular staple housed within cartridge 22. Anvilplate 90, as shown in FIG. 2A, is provided with two opposed tangs 92 aand 92 b which extend inwardly to engage complementary engagement slots93 b (only one is shown) in anvil support beam 80 during fabrication andassembly (see FIG. 10). The cross-sectional configuration of anvil plate90 is dimensioned to complement the cross-sectional geometry of supportbeam 80 (see FIG. 9). More particularly, cavity 97 which extends alongthe length of anvil plate 90 corresponds to a similar channel formed insupport beam 80. These areas accommodate shank 35 (see FIGS. 6A-6C) andknife blade 36 as they translate distally to form an incision in stapledbody tissue during a stapling operation.

A pair of rectangular apertures 95 a and 95 b are formed in anvil plate90 adjacent the proximal end thereof for receiving a pair ofcorrespondingly positioned flanges or projections 96 a and 96 b whichproject upwardly away from the tissue contacting surface (see FIGS. 2and 4C). The interaction between aperture 95 a, 95 b and flanges 96 a,96 b ensures that cartridge 22 and anvil plate 90 are properly alignedwith one another during a stapling procedure. Flanges 96 a, 96 b arespaced proximally of tissue stop portion 61 (see FIG. 3) of retentionchannel 14. Tissue stop portion 61 and the distal edge 13 of handleportion, best seen in FIG. 3, cooperate to prevent tissue from extendingproximally.

While the above disclosure has related to a wound closure materialapplicator assembly operatively associated with the staple cartridgeportion of stapling apparatus 10, it is envisioned and within the scopeof the present disclosure that a wound closure material applicatorassembly can be operatively associated with the anvil portion ofstapling cartridge 10. In particular, as seen in FIGS. 9A-9F, exemplarywound closure material applicator systems are shown in/on/along anvilplate 90.

In FIG. 9A, anvil plate 90 includes a row of apertures 191 formed ineach of tissue contacting or working surfaces 90 a extendingsubstantially along a length thereof. As seen in FIG. 9A, a conduit 8extends along each row of apertures 191 and is preferably secured to theinner surface of anvil plate 90. Each conduit 8 includes a plurality ofopenings 7 formed therein, preferably in registration with apertures 191formed in tissue contacting surface 90 a. In this manner, wound closurematerial “W” can be dispensed from apertures 191 (onto tissue contactingsurfaces 90 a) when wound closure material “W” is urged through conduits8.

As seen in FIG. 9B, the rows of apertures 191 can be formed in sidewalls 97 a which define cavity 97 or knife track, and conduits 8 areaffixed to the inner surface of side walls 97 a in such a manner so asto place openings 7 in registration with apertures 191 formed in each ofside walls 97 a. In this manner, wound closure material “W” can bedispensed from apertures 191 (into cavity 97) when wound closurematerial “W” is urged through conduits 8.

As seen in FIG. 9C, a row of apertures 191 can be formed in a top wall97 b which defines cavity 97 and a single conduit 8 is affixed to aninner upper surface of top wall 97 b in such a manner so as to placeopenings 7 in registration with apertures 191 formed in top wall 97 b.In this manner, wound closure material “W” can be dispensed fromapertures 191 (into cavity 97 or knife track) when wound closurematerial “W” is urged through conduit 8. Alternatively, as shown in FIG.9D a conduit 8 with apertures 7 in its lower surface can be placed incavity 97 and secured to the outer lower surface of top wall 97 b.

As seen in FIG. 9E, a sac 192, containing wound closure material “W”therein, can be disposed in cavity 97, preferably affixed and/or securedto the walls defining cavity 97. In this manner, as knife blade 36 isdistally advanced through cavity 97 of anvil 90, knife blade 36 slicesor otherwise ruptures sac 192 thereby releasing/dispensing wound closurematerial “W” onto knife blade 36 and/or onto tissue or the knife cutline and/or the staple lines. Alternatively, as seen in FIG. 9F, a film193 can be placed over, preferably adhered to, at least the lipsdefining the entrance to cavity 97 and preferably also cavity 97 andforming pockets or recesses 91. Preferably, a distal and a proximal endof a portion or all of cavity 97 is also sealed. In this manner, asknife blade 36 is distally advanced through cavity 97 of anvil 90, knifeblade 36 slices through film 193 thereby releasing/dispensing woundclosure material “W” onto knife blade 36 and/or tissue or the knife cutline and/or the staple lines. Moreover, as the staples (not shown) arefired into forming recesses 91, film 193 is further ruptured there tothereby dispense/release additional wound closure material “W”. Film 193can be single or multiple layers and can be comprised of wound closurematerial.

Alternatively, as seen in FIG. 9G, a coating of, or capsules and/orcapillaries 194 containing, wound closure material “W” can be disposedin knife track or cavity 97 such that the same can be ruptured,dispensed or destroyed by knife blade 36 or some other structure,preferably moving through cavity 97, and deposited on or about tissue,the knife blade, etc. as described above.

It is envisioned that anvil plate 91 can be readily disposed of andreplaced with a new anvil plate upon completion of the individualsurgical step.

Referring again to FIGS. 2A and 2B, anvil half-section 11 b of staplingapparatus 10 further includes clamping handle 100 which is used tosecurely clamp tissue between the staple forming surface of anvil plate90 and the tissue contacting surface of cartridge 22. Clamping handle100 is pivotably mounted to anvil support beam 80 about a transversepivot pin which is not shown in the drawings. A pair of clamping hooks102 a and 102 b depend from clamping handle 100 for interacting withU-shaped clamping beam 104 supported within the internal cavity definedin handle portion 12.

When apparatus 10 is assembled prior to use, notched area 84 at proximalend 82 of anvil support beam 80 is engaged with the cooperating detents86 in the inner cavity 15 of body portion 12. Thereupon, anvilhalf-section 11 b is mated with cartridge half-section 11 a, andclamping handle 100 is disposed in the upright unclamped position shownin FIG. 2B. Subsequently, when body tissue is properly disposed betweenthe staple forming surface of anvil plate 90 and the tissue contactingsurface of cartridge 22, anvil half-section 11 b is pivoted towardscartridge half-section 11 a, about the detents in body portion 12, suchthat the distal ends of clamping hooks 102 a and 102 b are positionedimmediately adjacent the proximal end of the base of U-shaped clampingbeam 104. Concomitantly, flanges 96 a and 96 b engage apertures 95 a and95 b in anvil plate 90 to ensure proper alignment of the anvil and thecartridge.

Then, to securely clamp the captured body tissue, clamping handle 100 ispivoted from the position illustrated in FIG. 1A to that which is shownin FIG. 1B. At such a time, clamping hooks 102 a and 102 b engage thebase of clamping beam 104, locking the apparatus in a clamped condition.During clamping, the captured body tissue exerts a counter-force againstthe tissue contacting surface of cartridge 22 and the fastener formingsurface of anvil plate 90, urging the two structures apart. To overcomethese forces and prevent the proximal portion 82 of anvil support beam80 from bending, bearing surfaces are defined within retention channel14 to support the compressive forces generated during clamping. Inparticular, as illustrated in FIG. 4A, opposed bearing shelves 110 a and110 b are stamp formed in opposed walls 62 and 64 of retention channel14. The bearing shelves are positioned to abut the medial section ofanvil support beam 80 proximate the clamping handle pivot point.

It may also be desirable to provide a locking mechanism to preventreactuation of the apparatus after it has been actuated. For example, alocking member 120 shown in FIG. 11 can be positioned in the retainingchannel 114. Locking member 120 is biased to an upward engagementposition and each end extends through a window 141, 143 in the channel114. A T-shaped member 124 is positioned between the cam wedges 132, 134to bias the hook portion 122 out of engagement with the actuationchannel 144. Head portion 126 of T-shaped member 124 (FIG. 11A) isinitially retained in the cartridge by a pair of detents in thecartridge which extend into the knife slot. When the apparatus isactuated, head portion 126 of T-shaped member 124 is in the knife slot.

A second pair of detents (not shown) at the distal end of the knife slotengages head portion 126 of T-shaped member 124 to hold it at the distalend of cartridge 122 when cam wedges 132, 134 are advanced to the distalposition. When actuation channel 144 is retracted from the post-actuatedposition to the pre-actuated position, T-shaped member 124 remainsforward allowing hook portion 122 to return to the upward position andextend through the window 141 in retaining channel 114 to engage edge143 (see FIGS. 12 and 13A) of actuation channel 144 to preventadvancement of the actuation channel.

FIGS. 13A, 13B illustrate movement of the locking member 120 from aninitial non-engaged position (FIG. 13A) out of engagement with actuationchannel 144 to an engaged position (FIG. 13B) in engagement withactuation channel 144 to prevent distal movement thereof.

Referring now to FIGS. 14-16, there is illustrated, in sequential order,a staple firing operation in which a plurality of staples 24, preferablycoated with at least one wound closure material, are ejected fromcartridge 22 and driven against the staple forming surface of anvilplate 90 while knife blade 36, also preferably coated with at least onewound closure material, cuts the tissue forming a knife cut line. Inoperation, prior to firing surgical stapling apparatus 10, actuationsled 28 is in the proximal-most position shown in FIG. 14. At such atime, knife blade 36 is enclosed in protective housing 25 formedadjacent the proximal end of disposable loading unit 20.

To fire the apparatus, firing knob 50 (see FIG. 2A) is moved in a distaldirection. Accordingly, as illustrated in FIG. 15, actuation channel 44drives actuation sled 28 distally into and through cartridge 22. Duringits distal translation, the angled leading surfaces of cam wedges 32 and34 sequentially contact ejectors 26, urging them in a directiontransverse to the direction of movement of actuation sled 28. As aresult, ejectors 26 push staples 24 from their individual slots 22 a,driving each staple into a respective staple forming cup 91 in anvilplate 90.

Sequential firing of the staples 24 continues until actuation sled 28 isadvanced to the distal end of cartridge 22, at which time, all of thestaples once housed within cartridge 22 will have been ejected (see FIG.16). Thereafter, as shown by FIG. 16, wound closure material applicatorassembly 15 is actuated to dispense the at least one wound closurematerial “W” from openings 7 of the conduits 8 on or into the knife cutline formed by knife blade 36 and on at least one staple line to reduce,control and/or prevent bleeding along the knife cut line and the atleast one staple line. It is contemplated that the wound closurematerial applicator assembly 15 can be actuated simultaneously with thesequential firing of the staples 24.

Firing knob 50 is then retracted to its original position, cartridge andanvil half-sections 11 a, 11 b are separated, and the spent disposableloading unit 20 is removed from retaining channel 14. Subsequently, anew, fully loaded disposable loading unit 20 can be positioned inretaining channel 14 such that the slot 40 of actuation sled 28 engagesflange 42 of actuation channel 44 to enable re-use of the apparatus 10.Further, reservoir 4 may be replaced or refilled prior to re-use of theapparatus 10.

Another preferred embodiment of a surgical stapling apparatus accordingto the present disclosure will now be described with reference to FIGS.17-19. In FIGS. 17 and 18 a surgical stapling apparatus is showngenerally as 200. Fastener applying device 200 includes a housing 212including a stationary handle 214, a distally extending body portion216, and a transverse body portion 215. Transverse body portion 215 isconfigured to receive support frame 218. Housing 212 may be constructedfrom plastic material in the form of molded housing half-sections 212 aand 212 b. Housing half-sections 212 a and 212 b are fastened togetherby a plurality of screws 219. Preferably, housing 212 is constructedfrom fiberglass reinforced plastic, although other materials having therequisite strength requirements may be used.

A conduit 203 of a wound closure material applicator assembly 201extends approximately the entire length of housing 212. A distal portionof conduit 203 is supported by a first leg 224 of the support frame 218.The distal portion of conduit 203 extending along or aside first leg 224includes openings 205 for dispensing at least one wound closure material“W” therefrom to at least one staple line formed by surgical staples 221(see FIG. 19) during or after a staple firing procedure. Conduit 203 isin fluid communication with reservoir 202 of the wound closure materialapplicator assembly 201 storing the at least one wound closure material.Reservoir 202 is preferably a compressible bag-like structure. However,other types of reservoirs are contemplated such as syringe-likereservoirs. Depending on the application, conduits can be flexible,semi-rigid or rigid and can include an elongate needle with an elongatedbar extending through all or a portion of the needle.

Reservoir 202, as shown by FIGS. 17 and 19, is compressible andconfigured for placement between housing half-sections 212 a, 212 b ofsurgical stapling apparatus 200 for being compressed as trigger actuator264 is moved towards stationary handle 214.

The at least one wound closure material “W” can for example be anastringent, e.g., a sulfate of aluminum, e.g., aluminum sulphate, asdescribed herein. Surgical staples 221 are preferably also treated orcoated with the or another at least one wound closure material tofurther facilitate hemostasis and/or another desired effect.

FIG. 19 illustrates a perspective view of surgical stapling apparatus200 with the internal components of surgical stapling apparatus 200separated from each other. Surgical stapling apparatus 200 may be isfastened together using screws 219 that extend between housinghalf-sections 212 a and 212 b, although adhesives, ultrasonic welding,and other known fastening methods may also be used to fasten thecomponents of the apparatus together.

An anvil (not shown) is fastened to first leg 224 of support frame 218.Any known fastening technique may be used to fasten the anvil to firstleg 224. The support frame 218 is substantially U-shaped and includesfirst leg 224, a second leg 226, and a base portion 228. First leg 224extends substantially parallel to second leg 226. The support frame 218may be monolithically formed by bending a sheet of material into thedesired shape. Preferably, support frame 218 is constructed fromstainless steel, although other materials having the requisite strengthrequirements may be used.

Cartridge carrier 238 is slidably supported about second leg 226 ofsupport frame 218 and is movable towards first leg 224. Cartridgeassembly 222 includes a body 204 to having a distal face 206 which isspaced from an open proximal end 274. A pusher bar channel 208 extendsfrom the open end 274 through a portion of body 204. A plurality ofslots 210 house fasteners 221 (FIG. 19) and are configured to receivedistally extending fingers 276 of pusher bar 266. The slots 210 extendbetween the proximal end of pusher bar channel 208 and distal face 206of cartridge assembly 222.

Surgical stapling apparatus 200 has an approximation mechanism foradvancing cartridge assembly 222 and cartridge carrier 238. Anapproximating clamp 234 or lever is pivotably mounted about pivot member240 which is supported between housing half sections 212 a and 212 b inthe proximal end of housing 212. The approximating clamp 234 is movableinto engagement with a proximal end of clamp slide 236 to linearlyadvance clamp slide 236 within body portion 216. A plurality oflongitudinal slots 242 formed in clamp slide 236 are configured toreceive guide pins 244 to limit clamp slide 236 to a linear path oftravel.

The distal end of clamp slide 236 includes a pair of projections 246.The projections 246 are fastened within a pair of openings 248 formed ina proximal end of cartridge carrier 238, such that linear movement ofclamp slide 236 is translated to corresponding linear movement ofcartridge carrier 238.

Referring to FIG. 19, approximating clamp 234 includes an abutment end262 having a series of detents which are configured to be received inrecesses 258 and 259 formed in an angled proximal end 260 of clamp slide236. Angled proximal end 260 of clamp slide 236 and abutment end 262 ofapproximating clamp 234 are movable into engagement to advance cartridgeassembly 222 towards the anvil on the first leg 224. Preferably,approximating clamp 234 is constructed of plastic and clamp slide 236,cartridge carrier 238 and pusher bar 266 are constructed of stainlesssteel.

FIG. 19 illustrates the firing mechanism for applying the fasteners ofapparatus 200. The firing mechanism includes trigger actuator 264 andelongate pusher bar 266 slidably received in a channel formed in clampslide 236. Trigger actuator 264 is pivotable about pivot pin 268 intoengagement with a proximal end of pusher bar 266 to advance pusher bar266 with respect to cartridge carrier 238 and to compress reservoir 202.Pivot pin 268 is supported between housing half-sections 212 a and 212b.

The slots 242 of pusher bar 266 slidably receive the guide pins 244.Guide pins 244 limit pusher bar 266 to a linear path of travel identicalto that of clamp slide 236. The distal end of pusher bar 266 is formedwith a head portion 272 configured to move to through the open proximalend 274 of cartridge assembly 222 to effect ejection of fasteners 221.The plurality of distally extending fingers 276 are integrally formed onhead portion 272. Each finger 276 has a concave distal surfaceconfigured to engage fasteners 221 housed within cartridge assembly 222and engage the fasteners 221. Fingers 276 extend from head portion 272in a pattern that corresponds to the pattern that fasteners 221 arehoused within cartridge assembly 222. For example, the pattern may betwo staggered rows. Other patterns are also contemplated.

As illustrated in FIG. 19, the proximal end of pusher bar 266 has alocking surface 280 and a contact surface 282. The trigger actuator 264includes an engagement surface 284 which pivots into engagement withcontact surface 282 of the pusher bar 266 to distally advance pusher bar266 when trigger actuator 264 is squeezed.

When pusher bar 266 is in a retracted position, locking surface 280 ofpusher bar 266 is positioned to prevent engagement between engagementsurface 284 of trigger actuator 264 and contact surface 282 of pusherbar 266. Thus, locking surface 280 prevents firing fasteners 221 priorto sufficient approximation of cartridge assembly 222 and the anvil.Before trigger actuator 264 can be rotated counter-clockwise to ejectfasteners 221 from device 200, approximating clamp 234 must be rotatedtoward stationary handle 214 to advance clamp slide 236 distally. Thisfrees trigger actuator 264 for pivotal movement to fire cartridgeassembly 222 and eject fasteners 221.

An adjustment member 290 is provided in the distal end of apparatus 200to facilitate ejection of fasteners 221 from apparatus 200. Adjustmentmember 290 includes a cylindrical shaft 292 having a pair ofdiametrically opposed first and second flats 294 and 296, respectively.Cylindrical shaft 292 extends through an opening formed in second leg226 of support member 218 and through the distal end of a longitudinaladjustment slot 298 formed in pusher bar 266. Adjustment member 290 issecured to support member 218 by adjustment nut 291. Shaft 292 isrotatable to align one of opposed flats 294 or 296 with a proximal end299 of adjustment slot 298 to define a stop surface for pusher bar 266.Since flats 294 and 296 are formed at different depths into cylindricalshaft 292, shaft 292 may be rotated to change the position of the stopsurface to vary the stroke of pusher bar 266.

It is envisioned that, prior, during or after firing of cartridgeassembly 222 to eject fasteners 221, wound closure material applicatorassembly 201 is actuated to dispense the at least one wound closurematerial “W” from openings 205 of conduit 203 to the at least one stapleline defined by fasteners 21 and/or the knife cut line if there is oneto control and/or prevent bleeding along the knife cut line or at leastone staple line.

An alignment mechanism is operatively connected to the approximationmechanism to maintain alignment between cartridge assembly 222 and theanvil during approximation of the anvil and cartridge assembly 222. Amore detailed description of a surgical stapling apparatus similar toapparatus 200 is found in commonly assigned U.S. Pat. No. 5,964,394, theentire contents of which are incorporated herein by reference.

With reference to FIGS. 20 and 21, another preferred embodiment of asurgical stapling apparatus according to the present disclosure is showngenerally as 300. Surgical stapling apparatus 300 includes a handleassembly 312 and an elongated body 314 extending from handle assembly312. A disposable loading unit or DLU 316 is releasably secured to adistal end of elongated body 314. DLU 316 includes a tool assembly orend effecter 317 having a cartridge assembly 318 housing a plurality ofmetallic surgical staples (not shown) and an anvil assembly 320 movablysecured in relation to cartridge assembly 318.

The staples are preferably treated or coated with at least one woundclosure material “W” as shown in FIG. 16A above.

Handle assembly 312 includes a stationary handle member 322, a movablehandle member 324, and a barrel portion 326. Handle assembly 312includes housing 336, which is preferably formed from molded housinghalf-sections 336 a and 336 b, which forms stationary handle member 322and barrel portion 326 of handle assembly 312. Movable handle member 324is pivotably supported between housing half-sections 336 a and 336 b.

A conduit 303 of a wound closure material applicator assembly 301extends along a portion of handle assembly 312, along the entire lengthof elongate body 314 and DLU 316, and at least a portion of the entirelength of cartridge assembly 318 or anvil assembly 320 (here shown oncartridge assembly 318). As seen in FIG. 21, a distal portion of conduit303 includes openings 305 for dispensing at least one wound closurematerial “W” therefrom on at least one staple line formed by the staplesand/or on the knife cut line during a staple firing procedure. Openings305 preferably are directed toward or in the direction of the tissue tobe treated desirably in the area when the tissue has been perforated orcut.

Conduit 303 is in fluid communication with a reservoir 302 of the woundclosure material applicator assembly 301 which stores the at least onewound closure material “W”. Reservoir 302 is preferably a compressibletube, bag, sac or capsule. However, other types of reservoirs arecontemplated such as syringe-like reservoirs. A portion of conduit 303in communication with or couplable with a reservoir or source of woundclosure material can be provided in fluid couplable sections. Forexample, a DLU can have a portion of conduit 303 which can be joined orfluidly couplable with another portion of conduit that is provided onthe handle or shaft portion of the stapling instrument.

Reservoir 302, as shown by FIG. 20, is compressible and configured forplacement between housing half-section 336 a, 336 b of apparatus 300 forbeing compressed as movable handle member 324 is moved towardsstationary handle member 322. Accordingly, compression of reservoir 302causes wound closure material “W” to be urged through conduit 303 anddispensed from openings 305 along the staple line either prior to,during or after the staple firing procedure.

A rotatable member 328 is preferably mounted on the forward end ofbarrel portion 326 to facilitate rotation of elongated body 314 withrespect to handle assembly 312. An articulation lever 330 is alsopreferably mounted on the forward end of barrel portion 326 adjacentrotatable knob 328 to facilitate articulation of tool assembly 317. Apair of retraction knobs 332 are movably positioned along barrel portion326 to return surgical stapling apparatus 300 to a retracted position. Amore detailed description of a surgical stapling apparatus similar toapparatus 300 is described in U.S. Pat. No. 6,330,965, the entirecontents of which are incorporated herein by reference.

It is provided that other types of staplers from those described herein,for example, circular staplers, can be designed to include a woundclosure material applicator assembly for providing at least one woundclosure material along a knife cut line and/or at least one staple linebefore, during and/or after a stapling procedure to facilitate desirableeffects to the stapled and/or cut tissue.

It is provided that a number of different wound closure materials “W”can be individually dispensed, or a combination of the number ofdifferent wound closure materials “W” can be dispensed by the woundclosure material applicator assemblies disclosed herein.

It is envisioned that the openings (i.e., openings 7, 205 and 305) andmicrotubes 21, disclosed in the embodiments above, are closed or aresealed/covered over with a material having a region of reduced weakness,to thereby enable rupturing of the region of reduced weakness uponurging of fluid (e.g., wound closure material “W”) through the conduits.

Alternatively, it is envisioned that a seal (not shown) is provided inthe lumen of each conduit 8, preferably at a location proximal of theopenings formed therein or of the microtubes extending therefrom. Theseal maintains wound closure material “W” from prematurely entering theconduits and seeping out of the openings formed therein. Accordingly,when wound closure material “W” is urged through conduits 8, the fluidpressure ruptures the seal and wound closure material “W” enters intoconduits 8. It is further contemplated that a valve “V” (see FIGS. 1a-2B) can be provided along the length of conduit 8 or 8 a at a locationproximal of the openings formed therein or of the microtubes.

Although the subject apparatus has been described with respect topreferred embodiments, it will be readily apparent, to those havingordinary skill in the art to which it appertains, that changes andmodifications may be made thereto without departing from the spirit orscope of the subject apparatus.

1-13. (canceled)
 14. A surgical stapling apparatus for joining tissue,the surgical stapling apparatus comprising: a staple anvil plate; aplurality of staple forming recesses formed in the anvil plate; and awound closure material retained in the staple anvil plate for dispensingwound closure material into or onto the tissue during a firing of thesurgical stapling apparatus.
 15. The surgical stapling apparatus ofclaim 14, wherein the wound closure material is at least one of anadhesive, a hemostat and a sealant.
 16. The surgical stapling apparatusof claim 14, wherein the wound closure material is selected from thegroup consisting of adhesives, hemostats, sealants, coagulants, andastringents.
 17. The surgical stapling apparatus of claim 14, whereinthe wound closure material is selected from the group consisting of:aldehyde-based adhesive materials, albumin/glutaraldehyde materials,cyanoacrylate-based materials, fibrin sealants, and collagen-basedsealants, synthetic polymer-based sealants, synthetic polyethyleneglycol based hydrogel materials, fibrin-based hemostats, collagen-basedhemostats, oxidized regenerated cellulose-based hemostats, gelatin-basedhemostats, fibrinogen-thrombin combination materials, and sulphates ofaluminum.
 18. The surgical stapling apparatus of claim 14, wherein atleast some of the plurality of surgical staples is coated with the woundclosure material.
 19. The surgical stapling apparatus of claim 14,further including a knife blade operatively connected thereto, whereinthe knife blade is coated with the wound closure material.
 20. Thesurgical stapling apparatus of claim 14, wherein the staple anvil plateis selectively removable from the surgical stapling apparatus.
 21. Thesurgical stapling apparatus of claim 14, wherein the staple anvil plateincludes at least one longitudinally extending conduit defining a row ofapertures formed in a tissue contacting surface of the staple anvilplate, wherein the wound treatment material is at least one of retainedin and communicated through each conduit.
 22. The surgical staplingapparatus of claim 14, wherein the staple anvil plate includes a pair oflongitudinally extending conduits each defining a row of aperturesformed in a tissue contacting surface of the staple anvil plate, whereinthe conduits are disposed outboard of the staple forming recesses, andwherein the wound treatment material is at least one of retained in andcommunicated through each conduit.
 23. The surgical stapling apparatusof claim 14, wherein the staple anvil plate includes at least onelongitudinally extending conduit defining a row of apertures formed in awall of a knife track of the staple anvil plate, wherein the woundtreatment material is at least one of retained in and communicatedthrough each conduit.
 24. The surgical stapling apparatus of claim 23,wherein the at least one longitudinally extending conduit is disposedalong an upper or lower wall of the knife track, wherein the upper orlower wall of the knife track defines apertures that are in fluidcommunication with the at least one longitudinally extending conduit.25. The surgical stapling apparatus of claim 14, wherein the stapleanvil plate includes a pair of longitudinally extending conduits eachdefining a row of apertures formed in opposed walls of a knife track ofthe staple anvil plate, and wherein the wound treatment material is atleast one of retained in and communicated through each conduit.
 26. Thesurgical stapling apparatus of claim 14, wherein the staple anvil platedefines a knife track, and wherein the wound closure material isretained within the knife track.
 27. The surgical stapling apparatus ofclaim 26, wherein the wound closure material is retained in at least oneof a sac, a conduit, and capsules disposed in the knife track.
 28. Thesurgical stapling apparatus of claim 14, wherein the staple anvil platedefines a knife track, wherein the wound closure material is disposedwithin the knife track and the plurality of staple forming recesses, andfurther comprising a film secured to a tissue contacting surface of thestaple anvil plate and overlying the knife track and the plurality ofstaple forming recesses.
 29. In a surgical stapling apparatus forenhancing one or more properties of body tissue that is or is to berepaired or joined, wherein the surgical stapling apparatus includes: astaple anvil positioned on a distal end of the stapling apparatus, thestaple anvil defining a longitudinally extending knife track; and astaple cartridge positioned adjacent a distal end of the staplingapparatus and juxtaposable relative to the staple anvil, the staplecartridge defining a longitudinally extending knife track, theimprovement comprising: a driving member supporting a knife blade andbeing supported in the surgical stapling apparatus for axially advancingthe knife blade through the knife tracks of the staple anvil and thestaple cartridge; and a wound closure material disposed on a surface ofthe knife blade, wherein the wound closure material is transferred tothe body tissue as the knife blade is advanced through the body tissue.30. The surgical stapling apparatus of claim 29, wherein the woundclosure material is at least one of an adhesive, a hemostat and asealant.
 31. The surgical stapling apparatus of claim 29, wherein thewound closure material is selected from the group consisting of:adhesives, hemostats, sealants, coagulants, and astringents.
 32. Thesurgical stapling apparatus of claim 29, wherein the wound closurematerial is selected from the group consisting of: aldehyde-basedadhesive materials, albumin/glutaraldehyde materials,cyanoacrylate-based materials, fibrin sealants, and collagen-basedsealants, synthetic polymer-based sealants, synthetic polyethyleneglycol based hydrogel materials, fibrin-based hemostats, collagen-basedhemostats, oxidized regenerated cellulose-based hemostats, gelatin-basedhemostats, fibrinogen-thrombin combination materials, and sulphates ofaluminum.
 33. The surgical stapling apparatus of claim 29, wherein thewound closure material is at least one of fluid soluble and activatableupon exposure to fluid.
 34. A surgical stapling apparatus for enhancingone or more properties of body tissue that is or is to be repaired orjoined, the surgical stapling apparatus comprising: a staple anvilpositioned on a distal end of the stapling apparatus and having aworking surface; a staple cartridge positioned adjacent a distal end ofthe stapling apparatus and juxtaposable relative to the staple anvil,the staple cartridge including: a working surface; one or more rows ofindividual staple slots formed in the working surface thereof; aplurality of surgical staples individually disposed within theindividual staple slots; at least one conduit extending longitudinallythrough the staple cartridge; and a plurality of microtubes extendingfrom the at least one conduit and being in fluid communication with arespective plurality of openings formed in the working surface of thestaple cartridge, the plurality of openings being adapted to dispense awound closure material therethrough to an area between the workingsurface of the staple anvil and the staple cartridge; a driving memberfor firing the surgical staples from the individual staple slots andagainst the staple anvil; and a wound closure material applicatorassembly operatively associated with the stapling apparatus, theapplicator assembly including at least one reservoir in fluidcommunication with the at least one conduit of the staple cartridge, thereservoir containing a dispensable wound closure material therein. 35.The surgical stapling apparatus of claim 34, wherein the at least oneconduit includes a pair of conduits disposed one each on opposedoutboard sides of the staple slots of the staple cartridge.
 36. Thesurgical stapling apparatus of claim 35, wherein the microtubes and theplurality of openings formed in the working surface of the staplecartridge are angled toward a knife track of the surgical staplingapparatus.
 37. The surgical stapling apparatus of claim 35, wherein theat least one reservoir is actuatable to deliver the wound closurematerial therefrom so that the wound closure material is dispensed fromthe plurality of openings formed in the working surface of the staplecartridge.